Print edition: 
Calm. That's not a word one hears much these days, but calm is what some are urging in the wake of a federal report on breast cancer screening.
Released Monday, the report has caused a stir with its recommendation that women in their 40s don't need annual mammograms and that self-exams no longer should be part of a doctor's instructions to female patients.
The timing of the report in the midst of a health care reform debate about reducing medical costs also has eyebrows raised. Health and Human Services Secretary Kathleen Sebelius responded Wednesday that the task force does not set federal policy and said that women should continue to get regular mammograms starting at age 40.
Meanwhile, Susan G. Komen for the Cure, the worldwide advocacy organization, is aiming for a measured — strategic — tone. It would be a mistake to overreact, said Eric Winer, Harvard University oncologist and chief scientific adviser to the Komen group.
Instead, Nancy Brinker, Komen founder and the woman responsible for "pinking" the world, sees the report as yet another opportunity for activism. If current screening is imperfect, then why not make it better?
You don't get pink ribbons on everything from running shoes to electric mixers, after all, by going negative. Thus, Brinker sees the federal report as a good thing — a "clarion call" for funders, researchers and government to deliver a lower-cost, more-effective screening tool.
The Komen organization — which funds 1,900 education, awareness and screening programs around the world — isn't changing its own recommendations for annual mammograms and self-exams for women 40 and older. It may not be a perfect protocol, but Komen's goal is more access to screening, not less.
Still, both Brinker and Winer acknowledge that there's more agreement than disagreement with the findings of the report, issued by the U.S. Preventive Services Task Force. Areas of consensus include: that mammograms do save lives in both younger and older women; that it is a travesty that one-third of women in the world don't have access to screening; and that while imperfect, the mammogram is the best test we have.
Areas of controversy surround the when, whom and how often. As for breast exams, Winer said it's pretty widely accepted that teaching women to examine themselves is not more effective in detecting breast cancer than not teaching them. The fact that many women discover their own cancer probably means that women are aware of their own bodies and respond intelligently to changes or abnormalities.
Winer also said that the panel's findings were based on analysis of several large and well-conducted studies and that different conclusions probably are a function of "murky data."
"You can't conclude that they got it wrong."
Nevertheless, breast cancer is an emotional issue. Computer models aren't reassuring if you're a breast cancer victim. Or if someone you love might have survived with earlier detection.
Brinker understands the personal dimension on a profound level. A survivor of breast cancer, she lost her sister to the disease at age 36. Even so, she prefers action to reaction.
If Brinker has her way, the debate relaunched last week will lead to improved technology so crucial to detection. If history is any guide, we may soon expect to see new pink screening gizmos that are cheap, portable and accurate.
